Posters

Geographic corneal patch graft for geographic corneal melt in previous penetrating keratoplasty eye

Poster Details

First Author: D.Anwar IRAQ

Co Author(s):    R. Abubaker                    

Abstract Details

Purpose:

To report a case of corneal geographic ulcer due to Herpes Simplex keratitis led to total corneal stromal melt in that area and its management by a geographic corneal patch graft.

Setting:

Neega Eye Center

Methods:

Sixty eight year-old patient with history t penetrating keratoplaty 5 years ago for corneal melt and perforation. His condition was stable until recently, he developed pain and redness due geographic ulcer at the corneal recipient side causing dehiscence of the donor cornea. The corneal stroma of the geographic ulcer area melted and left a bare Descemet’s membrane with dehisced donor corneal edge. The gap prevented suturing of the dehisced edge. Therefore geographic corneal patch graft was fashioned to fit the melt area and sutured in place. The donor cornea is then sutured to the patch graft.

Results:

The patient best corrected visual acuity before the surgery was counting finger at 1 meters due to irregular astigmatism caused by raised donor corneal edge at the melt area. Geographic patch graft sealed the area and made it possible to suture the dehisced raised donor corneal edge to the patch graft. At postoperative week one, best-corrected visual acuity was 6/36.

Conclusions:

Geographic corneal melt at the area of interface of recipient and donor cornea in a previous penetrating keratoplasty eye that causes a dehisced donor cornea at the edge, is a difficult situation to manage. We introduced geographic cornea patch graft to fit in the melt area and also served as an edge to suture the donor cornea to it.

Financial Disclosure:

None